This is a blog by a former CEO of a large Boston hospital to share thoughts about hospitals, medicine, and health care issues.

Monday, May 03, 2010

I was wrong. I am sorry.

The Board of Directors of BIDMC today issued the following statement, which has been distributed to the media and to the entire hospital community.

The Board of Directors of Beth Israel Deaconess Medical Center, with the assistance of outside counsel, has completed its review of allegations made involving President and CEO Paul Levy. The review focused on a personal relationship with a former employee of the Medical Center. The Board found that over time the situation created an improper appearance and became a distraction within the hospital.

The Board believes that Mr. Levy should have recognized this situation in a more timely fashion and should have conducted himself in keeping with business protocol appropriate for the office of the CEO.

Mr. Levy agrees that it was a serious lapse in judgment and agrees with the Board’s conclusions. He has apologized to us and to the entire staff of the hospital.

Although our outside counsel found that Mr. Levy did not violate hospital policy, the board determined that he showed poor judgment and the board expressed its disappointment. Accordingly, the board has voted to take appropriate actions by:

1. imposing a financial penalty of $50,000 to be paid to the hospital in the current fiscal year.2. instructing that this matter be considered in determining the CEO's compensation for the next fiscal year.

Although in this instance, Mr. Levy has not lived up to the standards we set for our CEO, the Board also considered his exemplary record over the course of his tenure at BIDMC, the current performance of the hospital, his role as the chief architect of the hospital’s leading position in quality and safety, and his bold voice of leadership on public policy. Under Mr. Levy’s direction, the hospital has reclaimed its rightful place as one of the region’s preeminent providers of health care, medical education and research. The board again expressed its full support and confidence in his continued leadership, and considers this matter closed.

I have issued the following statement, which has likewise been distributed to the media and to the entire hospital community.

I appreciate the Board's thoughtful consideration of this issue. I agree with their conclusions that I made an error of judgment, and I believe the Board has acted appropriately.

Today I met with the Board, apologized to them again, and accepted their actions in resolving this matter. I regret that my behavior had such wide repercussions for the entire BIDMC community, and I will always feel sorry for any discredit I brought upon BIDMC. With the Board's vote, I look forward to putting this chapter behind us and working together in carrying out our public service mission.

I now here also issue these statements to my other community, the loyal readers of this blog, but I have one other comment.

For those of you who have come to rely on me for my pursuit of quality and safety of care and continuous process improvement in our hospitals, I hope that this series of events and revelations will not undercut the importance or validity of what I have been saying. I especially apologize to you if you feel that I have let you down and, in so doing, in any way weakened the case I have been making. We in the medical community have much to do in these areas. I hope we can together continue to engage in vigorous activity to help make health care safer and more patient-centered. I can't imagine more important goals for all of us to pursue.

You inspire me to do my best everyday. Everyone around you feels pride because of you and our patients really like it when you come around. I wonder how many patients are better because you make us want to do a better job?

Does the Board know how bad they look? Who are these people? I guess they don't know how people feel about you and what you've done here. They're making people really mad and they'll never know it because you're the only one who asks us what we think.

Paul, our travels in patient safety have taken us routinely into harm and apology, We have learned from Aaron Lazare, author of the seminal book “On Apology,” “… offering an effective apology, one that is honest and complete is a moral act and therefore worth the risk. It is an act of honesty, generosity, humility, commitment, and courage.” We have also learned that a culture that supports quality and safety is one that includes repentance and forgiveness.

It is an honor to be your friend, I celebrate your courage and particularly at this time, and I look forward to working with you to achieve the culture we all want for the people we are privileged to serve.

While I can't discredit your gracious and -- I will presume, sincere -- acceptance of the board's rebuke, I must make this observation: your personal life is YOUR, not mine, and I reject the notion that you owe me or anyone else an apology for something that has nothing to do with your duties as CEO, which it appears you perform admirably. I realize that our culture is tumbling into a place where there is no privacy, there is no separation of what is my business and yours, and I lament -- for me and for you -- that this incident is both victim of and further fuel for that trend. Until they tell me you were stealing from the till, what you do on your own time -- whatever relevance it may have to your marriage vows is none of my business, and no apology is needed. I don't know which to hope for: that you realize this is true, and that you understand public sentiment nevertheless compels obeisance (meaning you are aware of the hypocrisy dictated by public norms), or that you sincerely think you have something to apologize for -- either of which would be a pity. It's not as if you're an evangelist minister running for president on a platform of family values; you're a CEO, bringing value to shareholders while serving your community. The bottom line is this: you do good in your work. Keep it up, and don't let them think they own your thoughts as well as your existence 24x7, outside the hospital as well as in.

As a daily and nonlocal reader of your blog, I find your candid observations on health care consistently informative and illuminating. I find your handling of this "distraction" consistent with the accountability and transparency you stand for on health care issues. I appreciate your continued commitment - even when uncomfortable.

Having kept up with your blog for a number of years it is notable that your apology and overall response to this bump in the road is as consistent as all the other leadership challenges you often write about. This seems surely as strong a test of human character as I can possibly imagine.

You have lived it out quite admirably.

I think your hospital and board of directors are getting far more than they had imagined, but still their response leaves me feeling a bit sour.

So, now let us see if they can be the better for it, especially when their own failings are dissected and aired out for healing. Pride does come before the fall, and there is, as always, time.

Are you people for real? Mr. Levy is running one of the most important organizations in Boston...patients, staff, insurers, hr people (the public) have a right to know what is going on. Paul Levy had been admirable in speaking often about value of transparency. He should live up to his own words and people will get past it if it was really not that bad.

This is a comment that I posted on Gruntdoc's post about your apology. Reposting it here…

I am perplexed by a few aspects of this since I saw Paul’s post in facebook and some of the comments there.Why would the BIDMC board deem it necessary to poke into the personal affairs of one of their employees, especially as it involves, in their own words, “a personal relationship with a former employee.” And this after an “outside counsel found that Mr. Levy did not violate hospital policy.”The glowing praise for his “bold voice of leadership on public policy” and expression of “full support and confidence in his continued leadership” notwithstanding, the combination of a huge pecuniary penalty and “threat of more in contract negotiations” hints at a political/administrative squabble in the BIDMC board.Paul must have made a few enemies during his tenure as CEO and I personally believe some of them may have brought their sharpened knives to the table.

Full Disclosure: I’ve interacted with Paul on multiple occasions on twitter, facebook and our respective blogs and have met him personally once. And I think he’s a great guy.

I am a newcomer to this great source of information having discovered it in the process of writing a book. I am also a New Yorker and an attorney who has no knowledge of nor interest in the situation that led to the apology. I'm happy to skip today's message regarding internal matters and eagerly await tomorrow's.

The daily missives are wonderful insights into the workings of a hospital, health care delivery, and stories of patients and their care. Keep up that terrific flow of information. It is refreshing and useful to a broad community.

What is unclear here is whether Paul's personal relationship was with someone who was working at the hospital when the relationship began. The wording of the statement doesn't make this clear--it just says a "former employee of the Medical Center." Was the person a former employee when the relationship began? Did Paul's actions towards this person create conflicts or favoritism or discomfort for his colleagues at BIDMC, or the appearance of these? If the relationship was with someone at the hospital, it certainly brings it into the realm of relevancy for the board, particularly if it was not disclosed. If the CEO of any organization has a secret relationship with a colleague, let alone someone who works for him or her, it creates enormous problems, at least of appearance if not more.

I also want to mention, Paul, that I don't know if I "feel like" you have let me down because I don't know what you did. What I'd love to know if YOU feel like whatever you did let us down?

“Although in this instance, Mr. Levy has not lived up to the standards we set for our CEO, the Board also considered his exemplary record over the course of his tenure at BIDMC, the current performance of the hospital, his role as the chief architect of the hospital’s leading position in quality and safety, and his bold voice of leadership on public policy.”

I think the Board dealt with this matter in a fair and balanced way. We’re all human. Sometimes we make mistakes.

Its nice to know your human, Mr. Levy! Show me a great leader who didn't have a lapse in judgement at some point in their lives.

The transparency and humility you have shown is yet another behavior that I wish more leaders would adopt. I hope others recognize this, especially your board - do any one of them exhibit this kind of courage?

Thank you for staying the course - sometimes the greatest learnings come from our ability to withstand the burdens of our own mistakes. It makes us wiser, and more than ever, we need wise leadership.

You're a great leader and a fantastic person, really, it's not that big of a deal. You're human and the fact that this is made so public is honestly ridiculous. You have a right to privacy like everyone else.

How many people have never been in this situation? I'm pretty sure the board members aren't as perfect as they like to portray themselves.

Keep up the good work...inappropriate relationships or not, people here are happy and this hospital works because of your leadership. And it really is no one's business what any of us do behind closed doors.

I read your blog often.I comment occasionally, sometimes in a critical way.I do admire the drive toward transparency around quality and cost in healthcare.I am sorry to say, that in my opinion, I feel that you have lost your soapbox.We can't be sure from the wording of the statements, but it certainly seems based on your board's actions that you had a relationship with a female employee of BIDMC, someone who at least at some time worked directly for you, a real HR no-no at the least. For me, the issue of honesty (transparency) has less to do with the fact that you don't want to talk about it, fine. The issue has more to do that you and/or your HR department didn't seem to think it was an issue until someone made it one. Further than that, I would say there is an integrity issue, especially for someone who preaches integrity and transparency, in that you are (I think, correct me if I'm wrong) a married man.Personal or not, that soapbox you were on (and someone needs to be) is now not lifting you very high above the crowd.

Thanks for your apology. I was all set to unsubscribe to your blog when I read the first, breaking news reports. This is another instance where my procrastination paid off. You have made quite the impression by stepping forward with your public, sincere apology, versus what we usually get from public figures who admit, "mistakes were made." You have just made your blog all the more real and refreshing. Thanks. Chris Mitchell, a former Boston healthcare junkie, now living in exile in Chicago.

I second the sentiment that you owe no-one outside of your staff and your board an apology. I didn't need one. Your case is not weakened, and the few, vocal detractors who think this in any way impacts the credibility or validity of your transparency efforts and leadership in this arena will have something else to blather about soon enough I'm sure. Keep doing what you're doing.

I guess what I'm confused about is whether not this employee in question was a direct subordinate of Mr. Levy, whether or not this person received any sort of improper benefits from Paul (as in bonuses, higher salary, etc)and why this particular employee was let go from the hospital in the first place. I'm an employee at the hospital and I've heard many rumors. Most, if not all, of the rumors are highly critical of Mr. Levy’s role in the entire situation. Please understand, I'm impartial to it all. We all make mistakes. Who I feel really bad for is not Mr. Levy but Mrs. Levy and his family. I guess I'd like to know what exactly happened. It's just very unfortunate that this entire affair had occurred because BIDMC is a wonderful place to work and this certainly leaves a black eye on this institution.

I am an outsider who subscribes to your blog because of its valuable insights. I don't understand what took place, but I am impressed that you saw the importance of offering an apology to those who feel they deserve one. You have more of my respect because of it.

You have made yourself an icon of transparency with this blog and the way that you lead the hospital.

Did you put your "lack of judgement in a personal relationship" in the public eye on purpose or would it have come out anyway? Are you in fact modeling your personal transparency in the same way you have other incidents in the hospital?

Perhaps you have let some of us down. I am confident you will continue to lift our hospital up as you have in the past.

If we truly embrace transparency, than we must match it with forgiveness and the chance to rebuild.

I am a recent MBA in Health Care Leadership graduate who admires your work professionally. Thank you for the sincere apology and the professional manner in which you have handled yourself. No one is perfect and humans naturally want relationships. This does not deter my view of you as an exemplary leader and inspirational human being.

I am appalled to read the press accounts about what Mr. Levy did. His dishonest behavior is, in a word, disgraceful. And for board just to fine him is likewise disgraceful. He has to go.

Here is what what one newspaper reader wrote.

"Just another high falutin’, la-de-da kind of guy with an overwhelming sense of entitlement when it comes to women. . . . He belongs in the same trash heap as Tiger Woods, Jesse James, John Edwards, and on and on it goes."

Dr. Rabkin, Levy’s predecessor, must feel disgusted. And the founders of the Beth Israel must be turning over in their graves.

The board needs to cut it losses and get rid Mr. Levy; anything less will hurt the BIDMC’s reputation even more than it has been hurt to date.

Mr. Levy -I too am a hospital executive. I can think of two far more important pursuits than health care safety and quality, my family and my faith. Engage in these with the same energy and passion as you do your hospital work and all this will work itself out, and you will achieve more and be happier.

I am a CEO. Your conduct is abhorrent. You compromised the office which you hold. You compromised the integrity of the institution and your employees. Who knows, some may have quit or faced retaliatory action from you and your HR team for "acting out" in response to your irresponsible behavior. This blog is an extension of your arrogance. Best advice: RESIGN

As Ben Franklin once said, "It takes many good deeds to build a reputation, and only bad one to lose it."

The essense of tragedy, in classical terms, is embodied in the concept and the reality of the tragic flaw in the hero. Sadly, it appears in this instance, we are faced, not with a single lapse of judgement, but, more likely, a series of lapses of judgement that have tarnished your reputation. You have done the Dostoevskian going to the crossroads, declaring your sin and repenting it. What remains is the efficacy of the tincture of time to heal wounds.

Apology accepted. Like in the old joke, you acquire good judgment through experience, and experience is gained through the exercise of bad judgment.

Welcome to the New Age of Intolerance where what was once handled casually is now handled litigiously, and private matters are bandied about in public discourse without a care for the dignity of either party, only appealing to the prurient interest of the public. By 1st amendment standards, the infotainment provided by the "news" media should be declared pornographic.

I recently had the opportunity to come work at BIDMC, and could not be happier that I looked elsewhere. It is absolutely ridiculous that people are commending you for apologizing. Your actions as CEO are meant to provide an example to the rest of the organization. This blog claims to be "transparent," but clearly we are seeing a hand picked sample of stories of the life of BIDMC.

The Levy BDIMC case is part of our university business curriculum. As one who preaches the need for "champions" and "Change agents," in business, I'm always happy to see how students finally "get it" after studyin this case model. Paul Levy is an Organizational Development Specialists hero.